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Phasic Activity of Intrinsic Muscles of The Foot
Phasic Activity of Intrinsic Muscles of The Foot
Phasic Activity of Intrinsic Muscles of The Foot
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Publisher Information
Journal Joint
of Surgery
American
VOLUME 46-A, No. 3
Volume
APRIL
1964
Phasic
BY
Activity
1IO(ER MANN,
of Intrinsic
M.I)4, SAN
AND VERNE
Muscles
T. INMAN,
of the
MI)., PH.D4,
Foot
FRANCISCO,
lroiuu
the
Bionuechanic
Laboratory,
University
An muscles
electi-omyogi-aphic of the foot: digitoi-um the up quiet and standing. third down the
of brevis,
the
six flexot-
intrinsic hallucis on on
bi-evis,
muscle level toes; and
flexotbetween gi-ound,
fourth
Experimental
conditions down
a 10-degree
Sites
of eliot
1o(l(
I)Ia(-enwnt
: .1,
aI nlw-tor
digiti Fto.
minirm 1
B,
eXt
(11501
(ligit
oritns
1 irevis
: (
iii ursa
mit (ti)55(tis
1),
tI )(Iti(tOI
Irailtu-is
; E,
flexor
digitorum
brevis
I, flexor
lIallu(-is
1 revis.
Methods
Twelve
subjects
whose
ages
i-anged examined
in all
fi-om
which
fifteen
could
to twenty-five
pi-oduce over
pat-ticiwalking
pated.
pattet-it. recoided. placement pi-oduced electi-ode
*
None
1acls
had
foot i-ight
aisy
was
foot
caiefully
and
cases.
the
clsaractei-istics
the (1ig.
the
fot
The
was through was
site 1).
cleaned
one-centimeter electrodes
lidocaine stainless-steel
which
coissisted
placed
F;lecti-odes
piepared
tIl(
four
cleaning
Fltompsun
sti-inging
Program
it tlii-oiigls
awarul-wintnimnig
a 26-gauge
l)aI)ers. Septem-
( )nn at ltlG3.
of
\ernon Meeting
Resident-framnitsg
IeL(l
the Annual
Sttl(IV
Western b
\eterans
)rthopedie
Assouiatioti, rations
Iniversity
Seattlu,
Washington,
ber
25,
t This
(alifornia.
was
supported
Biomeelsanies
Lahoratorv,
School
of
Adniinist Medi(-ine,
Franu-iw-o
22,
41i9
470 disposable meter was into hai-b. then hypodermic The needle, withdrawn,
ROGER
MANN
AND
V. T. INMAN
and
then
to each
each muscle studied. Placerneiit of the electrodes each and individual If adequate a new
of the
as follows:
a Grass electrode
by a voluntary
loudspeaker
muscle
monitored
oscilloscope
after
rfhe
each experiment. electrode sites were covered with a bandage and the wires wei-e brought up the malleoli to a junction box, which was taped to the lateral aspect of the The subject wore a sock and soft, boot a rubber boot on each foot. The boot was the foi skin diving ; it was to the foot. The right cases the direct subject current distensible, had no heel or arch, was equipped with a metal strip on to eight a carbon-particle volts) was passed. or copper It was and readily on its heel mat thus through possible
leg.
walked (four
a small
to record heel and toe strike from the metal strips on the boot. In order to ensure the gi-eatest possible accuracy in relating the activity of each foot muscle studied to the whole walking cycle, electrodes were also placed in the tibialis anterior and
gastrodnemius muscles.
subject for
to walk experimental
speed.
Every arm
abnormal
movements,
taken;
two
or
three
steps;
the
to twelve inches) and bear equal was cairied out for approximately The electrical activity from
on plifier the subjects had a band right width leg through of twenty
weight on each foot. Electromyographic fifteen seconds. each muscle was relayed from the
an to overhead thirty boom thousand into the cycles amplifier. per
recording junction
The and second
box
aman
peak-to-peak noise level of five microvolts. signal was recorded on an eight-channel Offner were were
for
Dynagraph. and
made
the subject
each
heel
time
and
from
toe
the
contacts.
tibialis each
gastrocnemius the
as well
as from the
Data length
reduced
as
follows: was
For
condition, of variation
computed,
as well
mean for each individual step. The enlarged or reduced proportionately mental condition and for each superimposed, and a composite
thus obtained. (It
electromyographic by means
record for each step was then of a pantograph. For each experiof the activity individual of each steps muscle were was by this scale
walking
muscle, record
method; The
so that all
however, composite
the results
is obvious that the amplitudes of the records were altered only the phasic activity was considered in this study.) was then mathematically expanded to a teix-centimeter
could was be compared and expressed as per cent of the full
this
scale
obtained
the
ideal
or average
activity
which
is reported
PHASIC
ACTIViTY
OF
INTRINSIC
MUSCLES
OF
THE
FOOT
471
Results All or parts enough many was of the records obtained from eight of twelve subjects were accurate
to warrant reduction. technical problems that accii tate and voluntary not be recorded. cases, an electrical
The discarded records were inadequate because of the arose. In several cases, although electrode placement contractions Sometimes artefact produced normal electromyograms, device did probably flat-foot. phasic the heel-toe was produced, bilateral not record propby movement of Theiipatterns
electiodes, either within or outside the muscle. Thee of the eight subjects had asymptornatic
for level walking differed from the patterns of subjects was essentially no difference in electrical activity between subjects staiiding L(P(l (lxiling on the lVaII1iiig The the stance 11w electrical phase abductor activity of the six intrinsic and extensor muscles stair toes.
-
with normal feet. There normal and flat-footed down and up slopes, or
climbing
or
descending,
walking
studied
only
during became
digitorum
active at approximately hallucis, flexor digitorum at 3S, 40, aisd 28 per cent these both and pcitibiahis the
per cent of the cycle. brevis, and flexor hallucis of the cycle, respectively.
In normal feet, the abductoibrevis muscles showed activity In subjects with pronated feet, cycle. The activity was cent at in 35
muscles showed activity at 0, 26, and 14 per cent of the the noi-mal aisd pronated feet ceased ixear toe-off. [lie onset of activity in the interosseus and gastrocuemius 1. per cent of the cycle, cent and thei-e was rio
,
muscles
Activity ceased at (iS per between normal and pronated toe-off, for and activity muscles continued except
anterior
became
active
swing The
antei-ioi, LpsIope The at about digitorum activity the the the the Down
displayed
decreased
activity
before
heel-strike.
of electrical
activity
of four
of the
intrinsic
(Fig.
4) occurred
cent of the cycle, while the abductor began to show activity at 18 and at 25 pei cent of the cycle; the tibialis study until remained of the which that 34 per was cent active of the during
new
minimi and extensor cent. Gastrocnemius was the only one of (from intrinsic 60 per muscles cent of and of
muscles previous
under cycle
swing cycle).
active until just before toe-off, at 70 per cent. electromyogram was nearly constant, except foi that had two peaks of activity.
II a/king of the intriiisic muscles digitorum cent just cent became brevis and active the in the interosseus first 7 per muscles cent did of the not cycle
lour (Iig.
5). The
extensor
become
active until 42 and 16 per cles ceased activity until showed activity by 7 per
anterior was
of the cycle, respectively. None of the inti-insic musl)efore toe-off, at 67 per cent. The gastrocnemius of the cycle and ceased at 57 per cent. The tihialis
active from 52 per cent of the previous cycle until 18 pci- cent of the The amplitude was neai-ly constant throughout stance phase foi the inti-insic muscles and the gasti-ocnemius; the til)iahs anterior again showed two peaks of activity. new cycle.
VOL. 46-A, Ni). 3, APRIL 1964
472
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MANN
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INMAN
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MANN
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FOOT
473
lie/king
Foutand became ceased during stopped
(p
Stairs
intrinsic before at 33 per at toe-off. condition, muscles toe-off cent of the
showed
at 66 per cycle
cent
in the fit-st 4 pet- cent of the cycle 6). The dorsal interosseus muscle
gastrocnemius at
and the
Both active at
activity
Under
swiIsg
36
this
per
brevis for
61 and The
was
stat-ted
muscle
respectively.
amplitude
the
individual
constant
a/king
in all cases.
1)own
11
Stairs hallucis, became flexotactive digitorum in the first brevis, 9 per flexotcent hallucis of the cycle, bi-evis, cent cent aiid inthe of the of the
whereas
FIG.
Axis
8
joint.
of
subtalar
cycle, except for the pet- cent of the cycle. Under muscles per cent, There this both were respectively,
abductor the
digiti extensor
minimi
muscle, digitorum
whose
brevis
declined
gastt-ocnetnius
at
46
at
39
and
63
heel-sti-ike. Sta nding on Toes insti-insic muscles were active when the subject was standing on his toes.
All the
476 The
mius onset of activity was
ROGER
MANN
AND
V. T. INMAN
coincided silent.
with
that
the same for all the muscles. The activity of the gastrocneof the intrinsic muscles. The tibialis anterior muscle was
electrically
Quiet
Standing There was no electrical of activity activity recorded from the intrinsic seconds muscles, in some except subjects.
for
spot-adic
bursts
at intervals Discussion
of five
to ten
the different electromyographic it is appropriate to summarize of the joint has foot been and the muscles
patterns obtained the investigations that control and axis Hicks rotation
of motion subtalar
shown
by Manter
to pass (Fig.
to lateral
at an angle
of 16 degrees
to the
longitudinal
of the foot
Arrows
represent
resultant
axes
of
rotation
of
the
calcaneocuboid
and
talotsavicular
joints:
A,
the resultant axes are parallel joints is possible. B, supinated in the transverse tarsal articulation
to each other, free motion foot. When the resultant since each individual
from joint
to
inferior
at
42 degrees
to the
vertical.
The
motion
at the
by
when Wright
phase downslope
in motion
at the
joint
joint
as
in subjects
by
walking
Elftman
pronated
tarsal
feet.
or mid-tarsal described
consist joint.
about (Fig. joint
axes,
for
9).
are
In
tarsal of the
occur
occur tarsal
axis.
parallel
about
JOURNAL
PHASIC
ACTIVITY
OF
INTRINSIC
MUSCLES
OF
THE
FOOT
boid) are attempting to rotate through their own axes which it is obvious that the latter system is more stable mechanically. Since the transvei-se tarsal joint has the head of the talus subtalar tt-ansvet-se applied In supinator The hallucis in the it can fore support
transverse
no
in common
increased stability of the when excessive forces are surae foot muscle is fixed is a powerful on the hallucis, floor. flexor
foot just before toe-off. 10-A, it can be seen subtalar main joint when of the intrinsic
abductor
flexor digitorum brevis, and of the foot and perpendicular that the intrinsic muscles foot
joint; arch
abductor digiti minimi, lies essentially to the transverse tarsal joints. Thus, exert considerable flexion force on the role the in the main muscle contributors stabilization to the of the
muscle
part
of the
tarsal
and
play
the
principal thet-efore,
of the
PULL TRICEPS
Fm.
Approximate
direction
10-A
of force
FIG.
exerted
by
the
triceps
surae
of the
foot
(Fig.
10-B).
be kept
in mind
that
control
of the
transverse
each
tarsal
joint
is provided
participates
by
ligament, and hone. Exactly to what extent during locomotion is not known. It should tibia causes movement of the talus, which transvet-se these facts tarsal in mind joint to raise the
obtained
of these
to the
.
the
arch
With
the
t-egarding
pattettss
various
he seen
of the present
for the
foot, study.
most
we
part,
cati
the
now in-
electromyographic
in the
that,
experimental acted
it can
is especially
true
with
regard
to the
abductor
minimi, flexor hallucis brevis, abductor hallucis, and In level walking, the ititi-insic muscles in subjects with oiiset of activity in the main intrinsic mass at approximately as contrasted
ceased fi-om just
flexor digitorum brevis. normal feet showed the :35 per cent of the cycle, In all cases,
activity
with
before
0 to 26 per
toe-off.
cent
for the
downslope
flat-footed
walking,
subjects.
however,
activity
occurred
During
cessation
study are
just
before
in accord
observaduring supina-
tiotis statice
associates
degree
of subtalar tiormal
in a normal and a flat-footed subject (Fig. 11). In level walking, pronation occui-t-ed early and, in the
46-A. NO 3. APRIL 1964
VOl..
478
ROGER
MANN
ANI)
V.
T.
IXMAN
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THE
JOURNAL
OF
BONE
ANI)
JOINT
SURGERY
PHASIC
ACTIVITY
OF
INTRINSIC
MUSCLES
OF
THE
FOOT
at
33 to of the w-as
cent
of the sul)ject
10 pet
in the
of ptogressive
not-mal feet and 67 pet- cent can be linked to the pet-iod delayed
electt-ical
nmscles recorded in this study. 1)ui-iiig upslope valking, thete -as subject,
walking.
i-otation neat-ly
activity
in the the
in this
but
Once
the
normal
again, the
subject
showed
pattern cati be
pattetiis
of subtalat-
t-otation.
PER 0 CENT OF 50 WALKING 00 CYCLE
LEVEL
UPSLOPE
DOW
NSLOPE
40
UPSTAIRS
-40
-
40
DOWN
STAIRS
40L
FIG.
13 Positive indicates
fore and negative indicates
aft.
lore-and-aft
Modified
from
shear on Cunningham
the
foot
2
during
walking.
In the downslope pattern, one heel-strike on and, concomitantly, with If these transverse In level
IflltScles
can
in the intrinsic muscles in the subtalatjoint of the with normal about feet. the subtalar in the
.Just before
and are
to a lessetconsidered
degt-ee in the
be made. is no activity
cycle. of the
inwith
until
cent
In
a subject
ptonated toe-off
feet,
fot- the
10 pet-
cycle.
in level walking, when the foi-ces (Fig. 12) at-c greatest, maximum (Fig. 11) occurs and thete is optimum transverse tat-sal stabilization. subject, this stabilization begins at appi-oximately 40 per cent of by
N(
)
supiiiation In a notmal
the cycle as
demonstt-ated
Vol.
46-A,
the
1(11. 1164
degtee
aisd
rapidity
of
subtalat-
motion
and
confirmed
by
3, Al
ROGER
MANN
AND
V. T.
INMAN
intrinsic
muscles.
In
a subject
with
pronated
this to in
stabilization starts in the first 10 per cent of the cycle and gradually toe-off. Again, this greatest period of subtalar rotation is paralleled the intrinsic muscles. In upslope walking, the degree of supination and transverse tion
Of
tarsal flexible
stabilizafore part
is delayed
until
the
center
passes
over
the
relatively
the foot at approximately place and there is optimum created delayed In by the activity walking
of the cycle ; rapid supination then takes tarsal stabilization for the forces (Fig. 13) delay requires in foot the stabilization foot to is paralleled be a rigid lever by arm
propulsion of toe-off. The in the intrinsic muscles. down a slope, the body
early in the cycle to counteract the moment magnitudes of the vertical and fore-and-aft downslope walking than for any of the other 13). Early supination 8 and transverse tarsal activity The closely
stairs,
created by the accelerating body. The shear floor reactions at-c greater for experimental conditions (Figs. 12 and stabilization occur together with eatly and descent of stairs ascent or descent of
the subject strikes each step with his toes and metatarsal heads first and the heel does not as a rule come into contact with the tread. Thus the foot is loaded very rapidly after initial contact. If one considers the excessive and rapidly applied load upon extent, would the fore part of the foot (Figs. 12 and 13) while ascending stairs 2, it is obvious that be essential to stabilize the body by no later is also during required during this experimental while descending and, to a lesser complete stabilization of the foot than 5 to 10 per cent of the cycle.
standing on the toes. It can be seen condition that all the intrinsic in the evidence intrinsic muscles of postural adactivity is not
muscles were active. When a person is standing quietly, there is no activity (except for short bursts of activity, which presumably are justments).
necessary
silence supports the concept arch of the loaded foot when Summary and Conclusions
1. The 2. The the progressive walking. 3. Since axes the the foot of the principal 4. The transverse 5. Muscle at rest.
intrinsic electrical
muscles activity
of the foot act of the intrinsic at the subtalar joint exists tarsal
as a functional unit. muscles of the foot during between joints, they level, the upslope, intrinsic may
relationship transverse
of the foot during intrinsic muscle than does to support the normal the arches
References
1.
2.
3.
4.
Action of the Subtalar Joint. Prosthetic l)evices Research Project, University of California, Berkeley. Series 11, Issue 24, May 1953. CUNNINGHAM, D. M.: Components of Floor Reactions During Walking. Prosthetic l)evices Research Project, Institute of Engineering Research, University of California, Berkeley. Series 11, Issue 14, November 1950 (reissued October 1958). ELVrMAN, HERBERT: The Ankle Joints and the Foot. In Human Limbs and Their Substitutes, edited by P. E. Klopsteg and P. D. Wilson, pp. 417-419. New York, McGraw-Hill, 1954.
CLOSE,
INI.kN, ELFTMAN, HERBERT:
J. R., and
V. T.: The
The
Transverse
Tarsal
Joint
and
Its
Control.
Clin.
Orthop.,
16:
41-46,
1960.
THE JOURNAL OF BONE AND JOINT SURGERY
PHASIC 5.
ACTIVITY of the
OF
INTRINSIC Foot.
MUSCLES
Joints.
OF
THE
FOOT
481
1953. Arch. J. Anat. Rec.,
Anat.,
6.
7.
Hicks, J. H.: The Mechalsics HicKs, J. H.: The Mechanics 88: 25-30, 1954. MANTER, J. T.: Movements
397-410, 1941.
WRIGHT,
I. The
of the
Foot.
Plantar
of the
and
Subtalar
HENDERSON,
Transverse
Action Joint
80:
8.
1). G.;
DE5AI,
S. M.;
W. H.:
Complex 1964.
I)uring
the Stance
Phase
of Walking.
J. Bone and
VOl..
46-A,
NO.
3,
A1RIL
1964